黛力新与阿米替林治疗脑卒中后抑郁的疗效比较

目的探讨黛力新与阿米替林治疗脑卒中后抑郁的临床疗效及安全性和对神经功能康复的影响。方法将80例脑卒中后抑郁患者随机分为黛力新组40例和阿米替林组40例。在治疗脑卒中的基础上,黛力新组口服黛力新治疗,早中各服用1片,阿米替林组服用阿米替林(中、晚)50～150 mg,疗程为6周。于服药治疗前及服药后2、6周末采用汉密尔顿抑郁量表和TESS量表评定抑郁疗效及不良反应,采用爱丁堡-斯堪的那维亚卒中量表评定神经功能缺损的程度。结果治疗6周末,黛力新组及阿米替林组显效率分别为85.0%和65.0%,有效率分别为95.0%和77.5%,神经功能康复率分别为87.6%和83.8%。汉密尔顿抑郁量表评分,黛力新组治疗2周末及6周末均较治疗前明显下降(P0.01),阿米替林组较治疗前亦明显下降(P0.05)。爱丁堡-斯堪的那维亚卒中量表评分两组治疗6周末均较治疗前均明显下降(P0.01)。两组不良反应比较差异有统计学意义(P0.05),黛力新组不良反应轻微。结论黛力新组治疗卒中后抑郁与阿米替林组疗效相当,起效快,安全性高,不良反应轻微,依从性好,加速患者神经功能的康复。

Comparison of deanxit and amitriptyline in treating post stroke depression

Objective To explore the curative effect of deanxit and amitriptyline in treating post stroke depression (PSD) and alleviating neurologic impairment. Methods Eighty PSD cases were randomized into deanxit and amitriptyline group, with 40 cases in each group. Two deanxit tablets were adopted for cases in the deanxit group, twice a day. And amitriptyline with the dose ranging from 50 mg to 150 mg was adopted for cases in the amitriptyline group. The clinical efficacy of the two groups were evaluated by using Hamilton rating scale for depression (HAMD) before treatment and the 2nd, 6th week after. Additionally, the treatment emergent symptom scale (TESS) was adopted to evaluate the adverse reactions in the two groups, and the Edinburgh-Scandinavia stroke scale (MESSS) was applied to assess the neurologic impairment. Results Both deanxit and amitriptyline can help relieve the symptoms of PSD patients. In deanxit and amitriptyline group, the significantly effective rate were 85% and 65%,the effective rate were 95.0% and 77.5%, and neurologic impairment recovery rate were 87.6% and 83.8% (P<0.01), respectively. Adverse reactions incident in deanxit group was lower than that in amitriptyline group (P<0.05). Conclusion Compared with amitriptyline, deanxit can definitely benefit PSD patients and improve the neurologic function, while the adverse reactions of it is milder.